Does Timing Matter? Examining the Impact of Session Timing on Outcome
Does Timing Matter? Examining the Impact of Session Timing on Outcome
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DOI：
10.1037/ccp0000120
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发表时间：
2016-12-01
影响因子：
5.9
通讯作者：
Resick, Patricia A.
中科院分区：
文献类型：
--
作者：
Gutner, Cassidy A.;Suvak, Michael K.;Resick, Patricia A.
目的：在疗效试验中，创伤后应激障碍（PTSD）的一线治疗通常每周进行两次。然而，治疗的频率有很大的变化（例如，例如，在一个实施例中，每周一次或每周两次）。此外，客户经常取消或重新安排治疗疗程，导致治疗疗程时间的变化更大。本研究的目的是探讨创伤后应激障碍治疗频率对治疗结果的影响。方法：136名创伤后应激障碍女性（M-年龄= 32.16 [ SD = 9.90]）随机接受认知加工治疗或长期暴露。PTSD症状结果采用临床医生-管理者PTSD量表进行测量，治疗频率和一致性采用治疗会议出席日期进行测量。会话频率可操作性使用会话之间的平均天数，一致性定义为治疗会话之间的天数的标准差。结果：分段增长曲线模型显示，会话之间的平均天数越高，PTSD症状减少的程度越小，会话越频繁，PTSD症状减少的程度越大（p <0.001，d = 0.82）。更高的一致性也与更大的PTSD症状减轻显著相关（p <0.01，d = 0.48）。频率的效应量大得多，表明治疗疗程之间的平均天数对治疗结果的影响大于一致性。随访分析显示，会议4和5之间的时间间隔较长，与较小的减少PTSD治疗outcome.Conclusions：更频繁的会议安排可能会最大限度地提高PTSD治疗效果。
Objective: First-line treatments for posttraumatic stress disorder (PTSD) are often implemented twice per week in efficacy trials. However, there is considerable variability in the frequency of treatment sessions (e. g., once per week or twice per week) in clinical practice. Moreover, clients often cancel or reschedule treatment sessions, leading to even greater variability in treatment session timing. The goal of the current study is to investigate the impact of PTSD treatment session frequency on treatment outcome.Method: One hundred thirty-six women (M-age = 32.16 [ SD = 9.90]) with PTSD were randomized to receive cognitive processing therapy or prolonged exposure. PTSD symptom outcome was measured using the Clinician-Administered PTSD Scale, and session frequency and consistency were measured using dates of treatment session attendance. Session frequency was operationalized using average days between session, and consistency was defined by the standard deviation of the number of days between treatment sessions.Results: Piecewise growth curve modeling revealed that higher average days between sessions was associated with significantly smaller PTSD symptom reduction, with more frequent sessions yielding greater PTSD symptom reduction (p < .001, d = .82). Higher consistency was also associated with significantly greater PTSD symptom reduction (p < .01, d = .48). The substantially larger effect size for frequency suggests that average days between treatment sessions impacts treatment outcome more than consistency. Follow-up analyses revealed a longer time interval between Sessions 4 and 5 was associated with smaller reductions in PTSD treatment outcome.Conclusions: More frequent scheduling of sessions may maximize PTSD treatment outcomes.